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Related Experiment Videos

Extremely preterm vaginal breech delivery en caul.

Jane R Richmond1, Lucie Morin, Alice Benjamin

  • 1Department of Obstetrics and Gynecology, McGill University, Women's Pavilion, Royal Victoria Hospital, Montreal, Canada. jane.richmond@muhc.mcgill.ca

Obstetrics and Gynecology
|June 8, 2002
PubMed
Summary

An "en caul" vaginal birth method for extremely preterm breech infants with intact membranes is described. This alternative delivery approach showed comparable neonatal outcomes to cesarean births, offering a viable option for specific cases.

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Perinatal Research

Background:

  • Extremely preterm breech infants (<26 weeks gestation) with intact membranes present unique delivery challenges.
  • Conventional assisted vaginal delivery may not be optimal for these high-risk neonates.
  • Cesarean delivery is often the default, but carries its own risks.

Purpose of the Study:

  • To present an alternative vaginal birth method for extremely preterm breech infants with intact membranes.
  • To compare the immediate neonatal outcomes of this "en caul" vaginal delivery with cesarean births.
  • To evaluate the feasibility of vaginal birth in this specific high-risk obstetric scenario.

Main Methods:

  • Retrospective review of singleton breech deliveries under 26 weeks gestation with intact membranes.

Related Experiment Videos

  • Identified nine "en caul" vaginal births following tocolysis.
  • Compared outcomes with six cesarean deliveries performed solely for preterm labor.

    • Main Results:

    • Vaginal delivery occurred later (4 days vs 1 day) after admission compared to cesarean.
    • Mean time from corticosteroid injection to delivery was longer in the vaginal group (90 vs 22 hours).
    • Neonatal outcomes, including 5-minute Apgar scores and cord pH, were comparable between groups; however, mortality was lower in the "en caul" vaginal birth group (22% vs 50%).

    Conclusions:

    • The "en caul" delivery method is a feasible alternative for vaginal birth in extremely preterm breech pregnancies with intact membranes.
    • This approach may offer comparable or improved neonatal outcomes compared to cesarean delivery in select cases.
    • Further research is warranted to optimize this delivery method for extremely preterm breech infants.